Division on Addiction

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NARCH Grant from NIH/IHS

"Promoting Cultures of Recovery in Tribal Nations," Co-PIs: Debi LaPlante, Ph.D., Sarah Nelson, Ph.D., and Martina Whelshula, Ph.D.

The Healing Lodge of the Seven Nations (HL), a youth residential chemical dependency treatment center, serves youth from seven tribal nations (from Idaho: Coeur d'Alene Tribe, Kootenai Tribe and the Nez Perce Tribe; from Washington: The Confederated Tribes of the Colville Reservation, Kalispel Tribe of Indians, and the Spokane Tribe of Indians; and from Oregon, the Confederated Tribes of the Umatilla Reservation) and beyond. Recognizing the lack of programmatic research regarding best practices for supporting adolescents' recovery within tribal nations, HL has developed a research partnership with the Division on Addiction, Cambridge Health Alliance, a Harvard Medical School Teaching Hospital (DOA). This partnership is the Center for Indigenous Research, Collaboration, Learning, and Excellence (CIRCLE). CIRCLE is excited to announce that it received an NIH/IHS Native American Research Center for Health Award (NARCH). This CIRCLE-NARCH program, using a Tribal Participatory Research (TPR) approach, will address gaps in knowledge related to key components of sustainable recovery environments in tribal nations by conducting a multi-site strengths and needs assessment study of the seven nations' tribal recovery environment.

Grant from NCRG

"Risk & Resilience among Native American Youth in the Pacific Northwest," Co-PIs: Debi LaPlante, Ph.D., and Martina Whelshula, Ph.D.

Risky behaviors, such as alcohol and drug consumption, gambling, and violent or criminal activity, are a public health problem for youth across the United States (Eaton et al., 2010). Native American youth, especially, continue to be at elevated risk for some such harmful behaviors (Friese, Grube, Seninger, Paschall, & Moore, 2011), and little is known about their engagement in other behaviors (e.g., gambling). Consequently, it is important to continue to examine risky behavior among Native American youth. Likewise, it is equally important to pay as much attention to protective factors against risky behavior. Working with Native American tribes to gain information about risky behavior and protective factors will enable the development of programs that address these issues and maximize wellness. To gain information about areas of strength and those that require improvement, the proposed project will partner with The Healing Lodge of the Seven Nations (HL), a residential youth chemical dependency center that serves the Inland Tribal Consortium (ITC), to engage tribal youth in a mutually-developed brief risk and resilience assessment during planned community events. We have secured an agreement with HL and representatives from the four ITC tribes (the Colville Confederated Tribes, Umitilla Tribe, Kootenai Tribe, and the Kalispel Tribe) that will host youth community events during 2014. The assessment includes central risk behaviors (e.g., gambling, alcohol use, violence) and resilience factors (e.g., Native American enculturation and family connectedness) that have well-validated reliable brief assessments available.

Grant from The Tung Wah Group of Hospitals

"Clinical Research & Training Collaboration between the Tung Wah Group of Hospitals Integrated Center on Addiction Prevention and Treatment and the Division on Addiction, Cambridge Health Alliance, a Harvard Medical School teaching hospital," PI: Howard Shaffer, Ph.D., C.A.S.

The purpose of this project is to guide a multi-year evidence-based clinical research and training program located at the Integrated Center on Addiction Prevention and Treatment (ICAPT) in Hong Kong. We intend this program of activities to lead to enhanced treatment outcomes and provide the architecture for establishing ongoing clinical studies, including prospective longitudinal designs and randomized clinical trials. This architecture will provide the setting for future research activities at ICAPT as well as both clinical and research training. To this end, we will establish a training and development program that includes ethics, clinical, and research activities; this program will feature a “train the trainers” approach to multiply training experience effects. In addition to web based clinical and research training, selected Tung Wah staff will participate in the annual Harvard Medical School Continuing Medical Education live course in Addiction Medicine, offered by the Division on Addiction, and partake in the Division’s Continuing Medical Education Distance Learning courses, administered by Harvard Medical School.

Grant from OJJDP with the Cambridge Police Department

"Safety Net Collaborative Outcome Evaluation"

Katerina Belkin, B.A., Sarah Nelson, Ph.D., and Howard Shaffer, Ph.D., C.A.S.

The Cambridge Police Department (CPD) has set up a Safety Net Collaborative to promote mental health and limit youth involvement in the juvenile justice system through coordinated services for Cambridge youth and their families. Safety Net's diversion program targets first-time juvenile offenders and focuses on connecting them to the necessary services and programs to prevent recidivism. The Cambridge Department of Human Service Program assists the CPD in connecting kids in the program to five youth centers located throughout the city. Cambridge Health Alliance (CHA) provides phone and in-person consultation, training, evaluation and treatment services as well as outreach with officers to schools and families. Diverted youth can seek treatment at CHA, or in other behavioral health settings. At its five-year juncture, the initiative needs clear measures of positive outcomes and a more specific plan for data collection and analysis. The Division on Addiction will work with the CPD's Community Relations Division to identify measurable predictor and outcome variables to look at whether involvement in the Safety Net program is linked to positive outcomes.

Grant from ABMRF: The Foundation for Alcohol Research

"The effect of tailoring a testimonial message on excessive drinking by personal relevance on implicit and explicit narrative persuasion," Co-PIs: Julia Braverman, Ph.D., and John Kleschinsky, M.P.H.

Research suggests that narrative persuasion (i.e., telling vivid stories to promote attitude change) might be an effective public health promotion technique. However, it is unclear whether making a narrative story more personally relevant increases its persuasiveness. This research program explores this possibility for excessive alcohol consumption. It is well known that alcohol abuse impairs various domains of life, e.g., health, social relationships, and career. The importance of these domains varies from person to person. Hence, some people are typically more concerned about their social relationships, whereas others pay more attention to their career, or health. We examine the effect of matching the message content to what individuals find most personally relevant with two experiments. For the first experiment, we will ask participants randomly assigned to read personally relevant, or not, stories about alcohol. We will determine whether matching personal relevance along three domains (relationships, career, or health) positively affects individuals’ psychological immersion into the story, alcohol related attitudes, and self-reported drinking. For the second experiment, we will use a priming technique to make a specific domain temporarily more salient (i.e., “activated”) to an individual. This will allow us to investigate if induced relevance to self can yield similarly positive alcohol-related health outcomes.

Multi-Year Grant with the Foundation for Advancing Alcohol Responsibility (FAAR; Formerly The Century Council) to Reduce Repeat DUI by Developing a Computerized Assessment and Referral System (CARS)

New research has identified that repeat DUI offenders often suffer from a number of psychiatric disorders (e.g., Shaffer et al., 2007), suggesting that untreated mental health issues contribute to the persisting rate of DUI. To combat this pressing public health problem and to build a foundation for expanded treatment, the Division of Addiction, with support from FAAR, has begun work to develop and test a computerized clinical report generator tool, the Computerized Assessment and Referral System (CARS), for use in DUI intervention and treatment settings. CARS will package a powerful mental health assessment tool, the Composite International Diagnostic Interview (CIDI: Kessler & Ustun, 2004) with a user-friendly interface, increased flexibility, and immediate personalized output, to create a tool that can be used easily by DUI facility staff to screen DUI offenders and target interventions to address comorbid mental health issues. Dr. Ronald Kessler, Professor of Health Care Policy at Harvard Medical School, co-director of the World Health Organization’s World Mental Health Surveys, and an original developer of the CIDI, and his team are collaborating with the Division on the development of CARS.

Shaffer, H. J., Nelson, S. E., LaPlante, D. A., LaBrie, R. A., Albanese, M., & Caro, G. (2007). The epidemiology of psychiatric disorders among repeat DUI offenders accepting a treatment sentencing option. Journal of Consulting and Clinical Psychology, 75(5), 795-804.

Kessler, R. C., & Ustun, T. B. (2004). The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research, 13(2), 93-121.

For the original press release, click here.

Free CARS Webinar on December 15


Computerized Assessment and Referral System (CARS): Revolutionizing DUI Assessment


Monday, December 15th at 2:00 PM EST

Host: Sarah Nelson, Ph.D.

Webinar offered by: The National Center for DWI Courts and the Foundation for Advancing Alcohol Responsibility


Among the repeat DUI offender population, there is a very high level of psychiatric co-morbidity and these mental health issues are often linked to recidivism. In response to this issue, the Computerized Assessment and Referral System (CARS) was developed by the Cambridge Health Alliance Division on Addiction to identify the presence of mental health and substance use issues among DUI offenders. CARS is a standardized mental health assessment that is based on the World Health Organization's Composite International Diagnostic Interview (CIDI) that provides immediate diagnostic information for up to 20 major psychiatric disorders. In addition, CARS generates referrals to services and interventions based on an individual's diagnostic information and zip code. This webinar is designed for a criminal justice audience that is interested in exploring ways to better assess the DUI offender population. It will discuss the need for, development of, and current implementation of this cost-effective assessment tool that allows a non-trained clinician, criminal justice practitioner, or program administrator to perform a diagnostic evaluation to inform integrated planning, case management, and treatment decisions. Run on free open source software, CARS generates user-friendly reports at the click of a button. The 30-minute screening tool and the full three hour assessment tool will be available for general use in 2016. Click here to register.


Cambridge Health Alliance Readiness for Gambling Expansion (CHARGE)

Cambridge Health Alliance is getting ready for gambling expansion in Massachusetts. The CHARGE Initiative is an education, information, and awareness effort that will help people dealing with gambling disorder. Read more about CHARGE here.

Online CME Course

Disordered Gambling in Your Practice: Information and Resources for Dealing with Disordered Gambling

Course Directors: Heather M. Gray, Ph.D., Debi A. LaPlante, Ph.D., and Howard Shaffer, Ph.D., C.A.S.

The Division is proud to announce the launch of our latest online CME course, Disordered Gambling in Your Practice: Information and Resources for Dealing with Disordered Gambling. The course is dedicated to increasing providers’ understanding of disordered gambling and its importance to their practice. To learn more about the course, or to register, please click here.

Division Staff Present New Research at the Harvard Psychiatry Research Day Poster Session and Mysell Lecture and the Cambridge Health Alliance Academic Poster Session

Research staff from the Division on Addiction present posters at the Harvard Psychiatry Research Day Poster Session and Mysell Lecture and the Cambridge Health Alliance Academic Poster Session.

Harvard Psychiatry Research Day Poster Session and Mysell Lecture - March 19, 2014

The Cambridge Health Alliance Academic Poster Session - April 9, 2014

Please click on the below links to view the posters.

Recruitment Opportunities for Studies


Click here for more information about a smoking cessation study, as well as studies for veterans.


Psychiatric epidemiology, nosology, and treatment: Considering Internet gambling


In this article, we consider behavioral addiction by examining the psychiatric aspects of disordered gambling. In particular, we illustrate these considerations with examples based on the growing evidence base associated with Internet-based gambling. We begin our review by focusing on gambling, the epidemiology of gambling disorders, and the place of gambling disorders within the psychiatric nosology. We include a critical discussion about the games that people play and whether certain games are associated with higher rates of gambling disorder. This discussion also includes an evidence-based consideration of the relationship between gambling exposure and adaptation to this experience. We conclude our review by discussing several issues associated with the shift from DSM-IV to DSM-5 diagnostic criteria as well as the treatment of gambling disorder. Throughout this review, we use the Syndrome Model of Addiction as an overarching guide. Click here to visit the Library & Archives page.


Fantasy sports, real money: Exploration of the relationship between fantasy sports participation and gambling-related problems


Participation in fantasy sports increases annually. Wagering on fantasy sports is a form of gambling and researchers have found that fantasy sports participants are more likely to engage in other forms of sports betting than non-fantasy players; however, no published studies have examined whether there is a relationship between fantasy sports participation and gambling-related problems. Our study examined whether fantasy sports participation is associated with gambling-related problems among college students. We assessed fantasy sports participation and endorsement of DSM-5 gambling disorder (GD) criteria among a large convenience sample (N = 1556) of college students via an online health survey. We found that 11.5% of respondents participated in fantasy sports in the past year, the majority of which were males. Logistic regression analyses indicated that males who play fantasy sports for money and females who play fantasy sports (for money or not) were more likely to experience gambling-related problems. Click here to visit the Library & Archives page.


Recently Published:

Gray, H. M., Tom, M., LaPlante, D. A., & Shaffer, H. J. (In Press). Using opinions and knowledge to identify natural groups of gambling employees. Journal of Gambling Studies, Online First. doi: 10.1007/s10899-014-9490-1 (Password Protected)

Nelson, S. E., Van Ryzin, M., Dishion, T. J. (In Press). Alcohol, marijuana, and tobacco use trajectories from age 12 to 24 years: Demographic correlates and young adult substance use problems. Development and Psychopathology, Online First. (Password Protected)

Planzer, S., Gray, H. M, & Shaffer, H. J. (2014). Associations between National gambling policies and disordered gambling prevalence rates within Europe. International Journal of Law and Psychiatry, 37(2), 217-229. doi: 10.1016/j.ijlp.2013.11.002 (Password Protected)

Tom, M. A., LaPlante, D. A., & Shaffer, H. J. (2014). Does Pareto rule Internet gambling? Problems among the “Vital Few” & “Trivial Many.” Journal of Gambling Business and Economics, 8(1), 73-100. (Password Protected)

© Division on Addiction. All Rights Reserved. Last Updated:  December 09, 2014